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J Thorac Cardiovasc Surg 2009;137:1286-1288
© 2009 The American Association for Thoracic Surgery

Brief Communication

Dual left ventricular restorations in a patient with cardiac sarcoidosis

Takeshi Shimamoto, MDa,*, Takeshi Nishina, MD, PhDa, Akira Marui, MD, PhDa, Masashi Komeda, MD, PhDa,b,c

a Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
b Department of Cardiovascular Surgery, Toyohashi Heart Center, Toyohashi, Japan
c Department of Cardiovascular Surgery, Yamato Seiwa Hospital, Yamato, Japan

Received for publication March 14, 2008; revisions received March 29, 2008; accepted for publication April 12, 2008.

* Address for reprints: Takeshi Shimamoto, MD, Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara, Sakyo, Kyoto 606-8507, Japan. (Email: shimamo@kuhp.kyoto-u.ac.jp).

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Formula

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Surgical ventricular restoration (SVR) remains a challenge in cases of idiopathic dilated cardiomyopathy. It is even more challenging when multiple ventricular segments are affected and located near the base of the left ventricle (LV). Here, we report a case wherein dual SVRs were performed successfully in a patient with cardiac sarcoidosis with complete atrioventricular (AV) block and dyskinesis of the basal septum and inferior wall. The method involved endoventricular patch plasty through a lateral ventriculotomy for partial left ventriculectomy (PLV).

Clinical Summary

A 62-year-old woman was referred to our hospital because of worsening dyspnea and deteriorating hemodynamics in New York Heart Association (NYHA) class IV. Her symptoms were refractory to diuretic therapy. She had had a permanent pacemaker implanted because of complete AV block 10 years earlier. She received a diagnosis of sarcoidosis with transbronchial lung biopsy 8 years earlier, and since then she was receiving 5 mg of predonisone to control the inflammation. A chest radiograph showed pulmonary congestion with cardiomegaly. Results of the coronary angiogram were not remarkable. An echocardiogram revealed diffuse LV hypokinesis with dyskinesis of the inferior wall, marked thinning of the dyskinetic basal septum, and severe . . . [Full Text of this Article]






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